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Totally confuse-How to move forward with my RO & 2nd opinion
Totally confused
67 years, Had HolEP (March 2025) biopsy 3+4=7 Decipher 0.17 TNM=0, PSA 1.2 (8/10/25) PSMA all clear except a small liaison ECE
2nd opinion says its a small and nothing to worry about for next 8–10 years, here is the caveat but schedule me of Cyberknife prep work for CT for placement of fiducial
My RO at UCSF says he does see nothing drastic in my PSMA- scans and reviewed it with me, and that I have nothing to worry about the next 10 years, this small liaison was already there before, and we just happen to have caught it due to HolEP. I also discussed with him the 2nd opinions advise with him, I was by RO to be careful with Cyberknife, due to the fact that HeLEP has a left a hole in the prostate and cyberknife will make it worse and may cause excessive bleeding. He told me that in order to really determine if there is cancer, it would be advisable to have another biopsy done and take next steps then and referred me back to my urologist.
Totally confused with the findings …and what to do next ,,any advice will be greatly appreciated
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Maybe UCSF is ticked off becuz I went out their institution to get 2nd opinion
I attend a monthly UCSF prostate cancer online meeting. Of course, most of the people on there are UCSF patient. Nobody’s ever expressed a problem with having a second opinion from a different doctor. A few of the people have gone to Marina del Rey and seen Dr. Scholz.
You’re just looking for more information so speak to them about it.
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1 ReactionIt is a common practice to ask for several opinions, some people here had 5 or even more - do not be hesitant ! Oncology departments are used to that and actually encourage patients to consider all possible treatments.
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2 ReactionsHello Everyone,
Good News to Share, Met my RO for 2 hours and went over all my result, he confirmed that there was nothing to worry about, ECE showing up in my PSMA_PET scan was all the liquid from the wound from HeLOP not healing fully (false positive) I asked him what would be the sure proof way to make sure, he referred me back to my urologist for a biopsy, went through Transrectal biopsy no issues at all, full recovery after 24 hrs- Biopsy results all 14 cores 3+3 perineural invasion not present, no extraprostatic tumor present
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4 Reactions@mauk That’s GREAT news! Please be sure to stay on schedule for 6 month PSA’s for a while.
Since you did have some 4’s in your original biopsy, that issue can arise once again; stay on top of it.
Phil
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1 Reaction@mauk
Get as many options you need to make an informed decision about your health and the Dr. you select
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1 Reaction@mauk
It’s nice to hear that you only have a 3+3. The PSMA Pet can be Unclear about what’s really there?. It also can’t see metastasis smaller than 2 1/2 mm and UCSF radiologist says even 5 mm is hard to see.
My brother was Able to go six years before his 3+3 turned into 4+3. That is not unusual. Keep up your PSA tests like others have said.
One thing puzzled me, You say 14 course but how many were 3+3, Not all of them, I’m sure, The way you wrote it sort of implied that but I think that’s Not what you meant.
@jeffmarc All were 3+3=6
@mauk
At the PCI conference, they said if more than six were 3+3 something should be done. Having all 3+3 is really on the edge of dangerous. Make sure to get a follow up biopsy within no more than a year.and check that PSA regularly. This is a sign of a somewhat aggressive lead up. Remember, they only get about one percent of the prostate when they do a biopsy.
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2 Reactions@jeffmarc Hi Jeff,
Thanks for your feedback I have follow up appointments with my urologist and RO next week, waiting to hear their prognosis and recommendation going forward. Will keep you guys posted-looks like active surveillance with PSA every 6 months and yearly biopsy.